Thrombosis is the pathological basis of cerebrovascular diseases with high disability rate and lethality rate, such as stroke, which is a disease process involving various factors, like blood vessels, blood, blood flow. Thrombosis is related to coagulation system, endothelial cell function and dysfunction of cell adhesion, etc. Antithrombotic drugs include anticoagulants, antiplatelet drugs and endothelial cell-targeted drugs. Commonly used clinical anti-platelet drugs include aspirin, ticlopidine and clopidogrel; platelet GP II b/11Ia receptor antagonists include monoclonal antibody like abciximab, synthetic peptide receptor antagonist like eptifibatide, non-peptide receptor antagonists like tirofiban and non-peptide mimetics like lanifiban.
After stroke attacked, the occlusive artery unblocked in a short time may restore the brain function, but continuous ischemia over a period of time will result in irreversible brain cell damage. The area around the irreversible injured ischemic center is available penumbra. Even the blood supply is restored in a certain time, part of brain cells still had delayed neuronal death, which will cause various related factors, such as the release of excitatory amino acids, nerve cells calcium influx and free radicals etc, especially production of free radicals is considered to be one of main factors causing brain dysfunction. In ischemic state, hyperthyroidism of arachidonic acid metabolism can lead to the increase of free radical production, and peroxidation of unsaturated fatty acids forming cell membrane phospholipids will cause cell membrane damage and increase the dysfunction of brain cells.
Cranial nerve protection is an important part of stroke therapy. Brain protective agent edaravone was firstly recommended according to evidences of evidence-based medicine in latest Japanese stroke treatment guidelines, which injected new life for the treatment of stroke. In the treatment of acute cerebral infarction, edaravone with cerebral protecting action was recommended. Clinical studies showed that edaravone was effective for improving the prognosis of patients with acute cerebral infarction (occurred within 72 hours), especially more significant within 24 hours of the onset.
